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Individual

SHARAD P MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3800 W 203RD ST, SUITE 202, OLYMPIA FIELDS, IL 60461-1184
(708) 679-2660
(708) 503-3861
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7240
(317) 528-4800
(317) 865-8319

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
036053461
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036053461
IL
Enumeration date
05/12/2006
Last updated
09/06/2013
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